【摘要】 目的观察血清炎性标志物水平与多囊卵巢综合征(polycystic ovarian syndrome,PCOS)及其伴发的胰岛素抵抗的关系。方法选取近5年我科收治的确诊为PCOS的患者142例,并按照年龄及体质指数配对选取同等例数的健康体检者作为对照组,观察两组性激素水平、测定肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、IL-8、C-反应蛋白(CRP)及补体C3水平及糖代谢等各项指标并对其与PCOS及胰岛素抵抗的关系进行单因素分析,并将其有意义的指标纳入logistic回归模型进行多因素分析。结果与对照组比较,PCOS组患者促黄体生成素/促卵泡生成素(LH/FSH)及孕酮明显低于对照组(P均<0.05),其余性激素水平两组无显著差异(P均>0.05)。PCOS组患者TNF-α、IL-6、IL-8、CRP、餐后2小时血糖、空腹胰岛素、餐后2小时胰岛素及HOMA指数明显高于对照组(P均<0.05),而两组空腹血糖及C3水平差异无统计学意义(P均>0.05)。对具有统计学差异的指标纳入logistic回归模型分析发现,TNF-α、IL-6、IL-8及CRP为PCOS的独立危险因素,且与PCOS患者胰岛素抵抗相关。结论PLOS患者TNF-α、IL-6、IL-8及CRP水平升高,并可以作为PCOS患者发生胰岛素抵抗的敏感检测指标。更多还原

【Abstract】 Objective To investigate the associations of serum inflammatory markers with polycystic ovary syndrome( PCOS) and combined insulin resistance. Methods A total of 142 confirmed PCOS patients admitted in the recent five years were selected as PCOS group,and 142 age- and body mass index( BMI)-matched healthy subjects were selected as control group. The sex hormones levels in two groups were observed. Tumor necrosis factor-alpha( TNF-α),interleukin( IL)-6,IL-8,C-reactive protein( CRP),complement C3 and related glycometabolism indexes were detected,and single factor analysis was performed to analyze their associations with PCOS and insulin resistance. The indexes with significant difference in single factor analysis were brought into Logistic regression model to perform multiple factor analysis. Results Compared with control group,follicle stimulating hormone( FSH) / luteinizing hormone( LH) and progesterone in PCOS group decreased significantly( all P < 0. 05),while the remaining sex hormones levels were similar in two groups( all P > 0. 05). Serum levels of TNF-α,IL-6,IL-8,CRP,postprandial 2-hour blood glucose,fasting insulin,postprandial 2-hour insulin and HOMA index in PCOS group were all significantly higher than those in control group( all P < 0. 05),while fasting blood glucose and C3 levels were similar( all P > 0. 05). Logistic regression model analysis showed that TNF-α,IL-6,IL-8 and CRP were the independent risk factors of PCOS and were correlated with insulin resistance. Conclusion Serum levels of TNF-α,IL-6,IL-8 and CRP in PCOS patients elevate,and they may be served as the sensitive indicators of insulin resistance in patients with PCOS.更多还原